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Factors that influence radioactive iodine use for thyroid cancer.
Thyroid. 2013 Feb; 23(2):219-24.T

Abstract

BACKGROUND

There is variation in the use of radioactive iodine (RAI) as treatment for well-differentiated thyroid cancer. The factors involved in physician decision-making for RAI remain unknown.

METHODS

We surveyed physicians involved in postsurgical management of patients with thyroid cancer from 251 hospitals. Respondents were asked to rate the factors important in influencing whether a thyroid cancer patient receives RAI. Multivariable analyses controlling for physician age, gender, specialty, case volume, and whether they personally administer RAI, were performed to determine correlates of importance placed on patients' and physicians' worry about death from cancer and differences between low- versus higher-case-volume physicians.

RESULTS

The survey response rate was 63% (534/853). Extent of disease, adequacy of surgical resection, patients' willingness to receive RAI, and patients' age were the factors physicians were most likely to report as quite or very important in influencing recommendations for RAI to patients with thyroid cancer. Interestingly, both physicians' and patients' worry about death from thyroid cancer were also important in determining RAI use. Physicians with less thyroid cancer cases per year were more likely than higher-volume physicians to report patients' (p<0.001) and physicians' worry about death (p=0.016) as quite or very important in decision-making. Other factors more likely to be of greater importance in determining RAI use for physicians with lower thyroid cancer patient volume versus higher include the accepted standard at the affiliated hospital (p=0.020), beliefs about RAI expressed by colleagues comanaging patients (p=0.003), and patient distance from the nearest facility administering RAI (p=0.012).

CONCLUSION

In addition to the extent of disease and adequacy of surgical resection, physicians place importance on physician and patient worry about death from thyroid cancer when deciding whether to treat a patient with RAI. The factors important to physician decision-making differ based on physician thyroid-cancer case-volume, with worry about death being more influential for low-case-volume physicians. As the mortality from thyroid cancer is low, the importance placed on death in decision making may be unwarranted.

Authors+Show Affiliations

Division of Metabolism, Endocrinology, and Diabetes, Department of Medicine, University of Michigan Health System, University of Michigan, Ann Arbor, Michigan, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23134514

Citation

Papaleontiou, Maria, et al. "Factors That Influence Radioactive Iodine Use for Thyroid Cancer." Thyroid : Official Journal of the American Thyroid Association, vol. 23, no. 2, 2013, pp. 219-24.
Papaleontiou M, Banerjee M, Yang D, et al. Factors that influence radioactive iodine use for thyroid cancer. Thyroid. 2013;23(2):219-24.
Papaleontiou, M., Banerjee, M., Yang, D., Sisson, J. C., Koenig, R. J., & Haymart, M. R. (2013). Factors that influence radioactive iodine use for thyroid cancer. Thyroid : Official Journal of the American Thyroid Association, 23(2), 219-24. https://doi.org/10.1089/thy.2012.0380
Papaleontiou M, et al. Factors That Influence Radioactive Iodine Use for Thyroid Cancer. Thyroid. 2013;23(2):219-24. PubMed PMID: 23134514.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors that influence radioactive iodine use for thyroid cancer. AU - Papaleontiou,Maria, AU - Banerjee,Mousumi, AU - Yang,Di, AU - Sisson,James C, AU - Koenig,Ronald J, AU - Haymart,Megan R, PY - 2012/11/9/entrez PY - 2012/11/9/pubmed PY - 2013/7/31/medline SP - 219 EP - 24 JF - Thyroid : official journal of the American Thyroid Association JO - Thyroid VL - 23 IS - 2 N2 - BACKGROUND: There is variation in the use of radioactive iodine (RAI) as treatment for well-differentiated thyroid cancer. The factors involved in physician decision-making for RAI remain unknown. METHODS: We surveyed physicians involved in postsurgical management of patients with thyroid cancer from 251 hospitals. Respondents were asked to rate the factors important in influencing whether a thyroid cancer patient receives RAI. Multivariable analyses controlling for physician age, gender, specialty, case volume, and whether they personally administer RAI, were performed to determine correlates of importance placed on patients' and physicians' worry about death from cancer and differences between low- versus higher-case-volume physicians. RESULTS: The survey response rate was 63% (534/853). Extent of disease, adequacy of surgical resection, patients' willingness to receive RAI, and patients' age were the factors physicians were most likely to report as quite or very important in influencing recommendations for RAI to patients with thyroid cancer. Interestingly, both physicians' and patients' worry about death from thyroid cancer were also important in determining RAI use. Physicians with less thyroid cancer cases per year were more likely than higher-volume physicians to report patients' (p<0.001) and physicians' worry about death (p=0.016) as quite or very important in decision-making. Other factors more likely to be of greater importance in determining RAI use for physicians with lower thyroid cancer patient volume versus higher include the accepted standard at the affiliated hospital (p=0.020), beliefs about RAI expressed by colleagues comanaging patients (p=0.003), and patient distance from the nearest facility administering RAI (p=0.012). CONCLUSION: In addition to the extent of disease and adequacy of surgical resection, physicians place importance on physician and patient worry about death from thyroid cancer when deciding whether to treat a patient with RAI. The factors important to physician decision-making differ based on physician thyroid-cancer case-volume, with worry about death being more influential for low-case-volume physicians. As the mortality from thyroid cancer is low, the importance placed on death in decision making may be unwarranted. SN - 1557-9077 UR - https://www.unboundmedicine.com/medline/citation/23134514/Factors_that_influence_radioactive_iodine_use_for_thyroid_cancer_ L2 - https://www.liebertpub.com/doi/10.1089/thy.2012.0380?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -